Here’s How Trump’s New Policy Would End Medicaid As We Know It

WASHINGTON, DC - MARCH 22: U.S. President Donald Trump listens to Seema Verma, administrator of the Centers for Medicare and Medicaid Service, during a Women in Healthcare panel in the Roosevelt Room at the White House March 22, 2017 in Washington, DC. (Mark Wilson/Getty Images)

Today, the Trump administration unveiled guidelines that allow states to take Medicaid away from people who can’t find jobs—for the first time in the program’s 50-year history. According to a letter issued today from the Centers for Medicare and Medicaid Services (CMS) to state Medicaid directors, states will now be allowed to strip Medicaid coverage away from
most working-age peopleThe new policy will apply to “non-elderly, non-pregnant adult Medicaid beneficiaries who are eligible for Medicaid on a basis other than disability”
if they aren’t working or participating in qualifying work activities for a set number of hours per week.

New analysis from the Center for American Progress estimates that as many as 6.3 million people could be at risk of losing Medicaid under this new policy.

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Adding so-called “work requirements” to Medicaid has long been on GOP leaders’ wish list. Most recently, it emerged as part of Congressional Republicans’ unsuccessful efforts to repeal the Affordable Care Act last year. And Republican governors in a slew of red states have been chomping at the bit to add work requirements to their Medicaid programs; while all eyes were on the health care debate in Congress, at least 10 states requested authority to do so last year alone, with the potential to impact 640,000 people. More states are likely to follow suit after the release of today’s guidance.

While the policy might sound reasonable at first blush, upon closer inspection it’s just another strategy for ripping health insurance away from the people who need it most—unemployed and underemployed workers struggling to make ends meet.

According to the Kaiser Family Foundation, about 25 million working-age people were covered by Medicaid in 2016. Most—roughly 60 percent—were working themselves, and nearly 80 percent lived in working families. And of those not currently working, 6 percent were looking for work, 30 percent reported caregiver obligations, 15 percent were in school, 9 percent were retired, and just over one-third reported facing health problems.

It’s just another strategy for ripping health insurance away from the people who need it most

Taking away these people’s health insurance isn’t just cruel; it’s wildly counterproductive. Study after study shows that having health insurance is associated not only with better health but also with increased work capacity, which translates into higher wages and earnings. Medicaid plays a central role in making it possible for people with disabilities and chronic health conditions to work, as it is the nation’s largest provider of home- and community-based services such as personal attendant care.

History also shows that work requirements not only fail to improve long-term employment outcomes—they actually leave people worse off.

In 1996, as part of the legislation that famously “[ended] welfare as we know it,” Congress converted Aid to Families with Dependent Children into Temporary Assistance for Needy Families (TANF) and introduced a new policy requiring most adult recipients to participate in qualifying work activities as a condition of receiving cash assistance. While some TANF recipients did initially experience gains in employment—thanks in large part to the strength of the labor market during the booming economy of the 1990s—those gains ultimately proved to be short-lived. Few TANF recipients were able to secure stable, long-term employment with decent wages. Many others were unable to meet TANF’s stringent work requirements at all, due to employment barriers such as caregiving obligations, health problems, low levels of education, and criminal records. As a result, they were left without assistance even though they hadn’t found work.

Notably, while the letter sent to state Medicaid directors today says Trump’s new policy won’t apply to pregnant women or people receiving Medicaid on the basis of disability, the guidance itself admits that this will fail to protect the many people with disabilities and health conditions who don’t fall into that bucket, noting: “CMS recognizes that individuals who are eligible for Medicaid on a basis other than disability (and are therefore classified for Medicaid purposes as ‘non-disabled’) may have a disability under the definitions of the Americans with Disabilities Act.”

A study by researchers at the University of Michigan released in December suggests that people with disabilities and health conditions make up a large part of the population at risk of losing Medicaid under this cruel new policy. Two-thirds of Medicaid enrollees in that state who were not currently working reported a chronic physical illness, 35 percent reported having a diagnosed mental illness, and one-quarter reported having a physical or mental condition that interfered with their ability to function at least half of the time.

Meanwhile, the letter also concedes that many people may need “supportive services” such as job search help, child care assistance, transportation, or disability-related supports in order to work. But it goes on to make clear that states cannot use federal Medicaid funds to provide these types of services and supports.

In short, work requirements don’t help anyone work. Rather, at their core, work requirements are premised on a set of myths about poverty. First, that “the poor” are some stagnant group of people who “just don’t want to work.” Second, that anyone who wants a well-paying job can snap her fingers to make one appear. And third, that having a job is all it takes to not be poor.

Reinforcing these myths is core to Trump’s divide-and-conquer playbook. That’s why he’s so keen to smear Medicaid and other popular programs as “welfare”—a term with a deeply racially charged history, evoking decades of racial stereotypes about who is poor in this country. By using dog-whistle terms like “welfare,” he’s betting that he can paint people who turn to Medicaid and other public programs to make ends meet as modern-day “welfare queens” so we don’t notice that he’s coming after the entire working and middle class.

Meanwhile, a big part of the story here is an unforgiving low-wage labor market dominated by poverty wages and unpredictable work schedules. A minimum wage worker in 2016 had to clock an additional 244 hours to earn the same amount in real terms as she did the last time Congress raised the federal minimum wage back in 2009. As a result, many low-wage workers need to turn to public programs such as Medicaid and nutrition assistance, which have come to function as work supports when wages aren’t enough.

If Trump wanted to keep his campaign promises to the “forgotten man and woman,” he’d embrace policies that address the real problems facing struggling workers and families, like raising the minimum wage. Instead, the president remains hell-bent on taking health care away from tens of millions of Americans, over the objections of the American people—and he’s made it clear that he’s done waiting for Congress.

Editor’s note: To get involved and fight back, visit HandsOff.org to learn more about the Hands Off campaign to stop cuts to health care and other basics that help families make ends meet.

Updated: This article was edited to include the number of people who would lose Medicaid in the ten states with pending waiver requests.

The Wind Chill is 46 Below and Our Roof Is Full of Holes

We live in a cabin in Trescott, Maine. Our nearest neighbors are a half-mile down the road in one direction and about two miles in the other, with woods surrounding us. There are two variety stores about 6 miles from us in either direction, and a larger store is 11 miles away.

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Our roof has been leaking for a few years. My husband patches whenever we are able to buy a bundle of shingles and tar, and covers the undone sections with plastic tarps. He has pretty bad arthritis but we can’t afford to hire anyone to help. If we did hire someone, it would use whatever savings we’re trying to scrape together for that elusive new, used vehicle. Meanwhile, we put repairs to our current car on a must-do list since it’s two-and-a-half months past inspection and we know it won’t pass. For example, we had a rusty gas filler pipe, so gas would puddle on the ground. To alleviate that we only put in $5 at a time—smaller puddle. You wouldn’t think that would be a $300 job, but when you add up the estimate for what else needed replacing it was closer to $400.

Both of us are collecting Social Security—I have additional income through part-time work with the Senior Community Service Employment Program. We qualify for food stamps, but an experience 35 years ago has made it a choice of last resort. It was our son’s eighth birthday. We splurged on strawberries and cream for a strawberry shortcake, and on steaks, for his birthday dinner. We may have had to scrimp the rest of the month but at least we would celebrate his birthday. The looks. The cashier and the woman behind me in line watched me handing over the food stamps, and then their eyes went to the steaks and strawberries, and then back to me with an expression I could only describe as scorn.

We built our cabin in 1980-81, and except for five years in Orono while my husband went back to school, we’ve lived there ever since. Yet the Maine State Housing Authority (MSHA) wants more proof that we live there before we can complete an application for heating assistance. We don’t have electricity—we heat with our wood stove—but we’ve had propane delivered here all this time, and bank statements mailed to this address. None of that counts to MSHA, so we don’t apply for heating assistance.

We live in a state of constant anxiety, making a good night’s sleep tough to come by.

Recently, things became harder for us when we discovered our cell phone account was closed. SafeLink had provided us with a phone that would work in our area. Then, for reasons unexplained, they terminated our service without notice. (Services that help low-income seniors seem to be getting cut, or made more difficult, quite a bit these days.) It’s mean to cut a service that in rural areas can be lifesaving. Our solution was to purchase a simple Tracfone and a card with minutes. The new phone doesn’t keep a charge longer than 2 days and sometimes doesn’t ring when calls come in.

We live in a state of constant anxiety, making a good night’s sleep tough to come by. It’s well-established that prevention is cheaper than crisis care. But if your state refuses to adopt Medicaid expansion—even after the people vote for it—a lot of people are S.O.L. That’s the boat we were in, and the boat some of our friends are still in. We have Medicare but it doesn’t cover hearing, eye care, and oral care. All luxuries. My husband went without glasses for three years after the ones he’d patched with duct tape had a lens fall out and shatter. We found you could get prescription glasses online fairly cheap, but first you had to have a prescription. As far as I know hearing aids aren’t available online cheaper. Luckily, that’s not an issue for us.

So, we make do. We feel grateful for fairly good health (‘cept for the arthritis). We try to save more—although it’s the time of year when a cord of wood at $260 is my two-week paycheck, nearly. We’ve hit a cold spell—forty-six below with the wind chill. The trip to the outhouse becomes less pleasant each morning it goes below zero. And I hope it doesn’t snow too soon, because I haven’t found a pair of winter boots in a thrift store that fits.

A Billionaire’s Bid to Bring Amazon to Detroit

When Amazon solicited bids this fall for the location of its new 50,000-employee headquarters, 238 North American cities tossed their hats in the ring. They’re competing with one another to put together the most attractive incentive package for the tech giant, offering everything from cash to large-scale infrastructure projects. And many of their proposals divert public funds—which would otherwise go to schools, public transportation, or other city services—directly into Amazon’s pockets.

Chicago, for instance, would allow Amazon to directly collect $1.32 billion in income taxes paid by its workers. Fresno, California’s bid creates a committee jointly run by Amazon and city officials to determine how to spend the taxes and fees generated by Amazon’s presence in the city. Newark, New Jersey is going the most direct route, with a $7 billion tax incentive package that includes an option for Amazon to dodge the city’s wage tax for 20 years.

Cities with less money have gotten more creative in their attempts to lure the company. Stonecrest, Georgia offered to annex 345 acres for Amazon to run its own city, named “Amazon, Georgia,” with Jeff Bezos as the appointed “mayor for life.” Kansas City’s mayor purchased 1,000 products on Amazon just so he could write product reviews persuading the company to come to his city. And Tucson, Arizona sent a 21-foot saguaro cactus to Amazon headquarters in Seattle (which the company rejected, saying they “can’t accept gifts”).

Yet perhaps the most noteworthy bid came from Detroit, not because of what it contains—the details of the bid are still private—but because of who submitted it. Unlike almost all of the other 237 proposals, Detroit’s bid wasn’t submitted by its city government or Chamber of Commerce. It was submitted by Dan Gilbert.

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With a net worth of $6.1 billion, Gilbert is Michigan’s richest citizen. He built his fortune mainly through his company, Quicken Loans, though he’s perhaps best known as the owner of the Cleveland Cavaliers. During Detroit’s foreclosure crisis, Gilbert invested heavily in downtown real estate, buying up blighted and struggling properties through his real estate company, Bedrock. To date, he’s spent more than $2 billion of his own money on Detroit real estate—slightly more than the city’s annual budget—and he now owns more than 70 properties downtown.

Amazon’s list of criteria for its new headquarters includes a metropolitan area with more than 1 million people, a “business-friendly environment,” and up to 8 million square feet to build its sprawling campus. Many cities are disqualified because they simply don’t have enough space—8 million square feet is more than the combined office space in the entire city of Wilmington, Delaware. But Dan Gilbert can meet this requirement on his own: He currently owns 15 million square feet of real estate in downtown Detroit.

Like many of our country’s beloved billionaires, Gilbert’s accumulation of wealth may have involved less-than-scrupulous practices. A suite of lawsuits against Quicken Loans allege that the company engaged in fraudulent and predatory lending. In 2012, the West Virginia Supreme Court awarded $2.8 million to a plaintiff after Quicken added a balloon payment of $107,015.71 on the end of a $144,800 loan after 30 years. In July, a federal district court fined the company $11 million in a separate class action suit that alleged that Quicken’s appraisers inflated the market value of customers’ properties, “putting them underwater on their loans from the start.” Quicken Loans has said it plans to appeal the ruling. Yet another lawsuit is still pending: The U.S. Justice Department alleges that the company violated the False Claims Act—which prevents corporations from defrauding government programs—and knowingly altered or overlooked information in loan applications.

Regardless of how Gilbert obtained his fortune, it’s given him immense power over his struggling city. A 2014 National Journal article, “Is Dan Gilbert Detroit’s New Superhero?”, describes Gilbert’s growing regional power: “elected office could hardly augment his financial influence over Detroit … Gilbert has established himself as Detroit’s de facto CEO.” Even though the article sounds like it was written by Gilbert’s public relations team—at one point it suggests that he’s the “savior of Detroit”—its description of his control over the city’s downtown is frightening:

In the absence of a functioning, solvent local government, Gilbert has taken it upon himself to confront safety concerns by installing a state-of-the-art surveillance system downtown to supplement an underfunded and undermanned Detroit Police Department. The ACLU says it disapproves of this given the potential privacy concerns but says it cannot prevent business owners from monitoring their own properties.

However, a journalist for Motor City Muckrakerclaimed that Gilbert’s company, Rock Ventures, wasn’t just monitoring its own properties. He interviewed building owners who claimed that the company installed cameras on their property without their consent. (Rock Ventures denies these claims, and Dan Gilbert referred to the journalist as “dirty scum.”)

Three years later, his power is still growing. In May, the Michigan state legislature passed the “Transformational Brownfield” bills—colloquially known as the “Gilbert bills”—which give him access to up to $1 billion in public funds for his development projects. The bills divert the income taxes paid by any resident or employee who moves into his buildings, creating a situation like that in Chicago’s bid for Amazon’s second headquarters—citizens no longer pay taxes to the city government; instead, they pay taxes directly to Gilbert’s real estate corporation.

Peter Hammer, director of the Damon J. Keith Center for Civil Rights, says the Gilbert bills “marked a dangerous shift between public and private.” Hammer says that you used to be able to say that Gilbert “was an entrepreneur using his own money,” so whether you approved of him or not, at least it was on his own dime. But now, that’s changed.

Detroit has been cutting deals with developers in an attempt to revitalize the city for at least a decade. In 2013, the city approved $283 million in taxpayer funds to finance the construction of a new Red Wings stadium—at least $18 million of which came from school funding, according to former Michigan House Representative Rashida Tlaib. And in 2007, Detroit’s city council gave Marathon Oil a $175 million tax break to expand its operations, with the understanding that they would hire more Detroiters. But the project only created 15 jobs for Detroit’s citizens, which means the city’s taxpayers paid more than $11 million per job. In return, Marathon Oil has been dumping petcoke, a petroleum byproduct, on the outskirts of the Detroit River. On windy days, this produces thick, black dust clouds that blow far beyond the banks of the river.

That trickle-down approach is what has allowed Gilbert to thrive while the rest of Detroit falls apart

The return on investment for subsidies to Gilbert’s Quicken Loans isn’t much better. Residential mortgage lending has completely dried up in Detroit. There were just 356 new mortgages each year on average from 2009 to 2014, compared with 6,103 from 2004 to 2008.

“You get this huge contrast downtown, where you’re getting huge public subsidies for development, and in your neighborhoods, you can’t even get a commercial mortgage to buy a house,” Hammer says.

That disparity has created what residents call “the tale of two cities.” The city is 142 square miles, but almost all of the media attention and investment—Gilbert’s included—goes to the 7.2 square miles that make up its gentrifying core. While Detroit is 83 percent black, this downtown core is overwhelmingly white.

In July, Rock Ventures appeared to brag about Detroit’s racial disparity in a downtown window ad. The ad featured an almost entirely white crowd next to the slogan “See Detroit like we do.”

Gilbert seems to have learned his lesson about advertising optics when he helped create the “Detroit Moves the World” campaign for the city’s Amazon bid. Their masthead video is narrated with a spoken word performance from Jessica Care Moore, a black activist and poet, and features rhythmic images of a diverse array of artists, scientists, and workers in the city.

The video is inspiring, but after years of uneven revitalization, it may prove fruitless. Aside from Gilbert, most people don’t consider Detroit to be a serious contender, in large part because its development has ignored the majority of its citizens. One of Amazon’s selection criteria is a robust transportation system that can easily handle an influx of 50,000 new workers. On this point alone, Detroit fails spectacularly. Its largest transportation project in recent years is a new streetcar line that only travels 3.3 miles up and down Detroit’s gentrified core. It was largely privately funded, and has been named “QLINE” in honor of one of its major backers, Quicken Loans.

Even if Amazon were to select Detroit for its new headquarters, there’s not much evidence to suggest that it would solve the crisis residents are facing. How would it help a family whose water has just been shut off, and who must find a new school for their kids because all the schools in the neighborhood have closed? It’s tempting to think that a profitable, futuristic firm like Amazon is just what a city needs to kick start its development. But that trickle-down approach is what has allowed Gilbert to thrive while the rest of Detroit falls apart.

Of course, it’s not Dan Gilbert’s job—nor is it Amazon’s—to ensure that the city’s residents have their basic needs met. But if Detroiters have to wait for a billionaire to save their city, they’ll be waiting forever.

The Tax Plan Isn’t Just About Taxes—It’s About Shredding the Safety Net

In a recent interview, Congressman Jim McGovern (D-MA) described the congressional Republican approach to government as “survival of the fittest.”

“If you’re well off, great, if you’re not—too bad,” he said.

McGovern is right. The congressional GOP tax bill, which is expected to win final approval today, is effectively a bid to weed out people struggling to make ends meet. It could have dire consequences for the social safety net—and for the 70 percent of us who will turn to a means-tested program like Medicaid or the Supplemental Nutrition Assistance Program (SNAP) at some point in our lives. And it could impact millions who expect to rely later in life on Medicare and Social Security.

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Think of it as a two-step project. A deficit-exploding tax giveaway to the very wealthiest corporations and individuals is step one. You cannot invest in the strategies that have been proven to help lift families out of poverty—we’ll get back to that in a moment—without adequate revenues. Not only will revenues take a hit at the federal level, but it’s expected that local and state governments will roll back investments in necessities like schools, drug treatment centers, pensions and more to lessen the tax burden on residents who will no longer be able to take the same federal tax deduction on property, state, and local income taxes.

Then, by adding $1.5 trillion to the deficit, the tax plan sets in motion the second step: in the name of deficit reduction, congressional Republicans will move to cut the programs that help Americans experiencing financial hardship have at least some shot at affording basic necessities like food, housing, health care, education, and a little dignity in our later years. Indeed, according to The Hill, House Speaker Paul Ryan intends to fast-track so-called “welfare reform” in 2018, in a bid to push it through with a simple majority. President Donald Trump is expected to sign an executive order reflecting similar priorities.

There is a persistent lack of education about what our safety net is, and who it benefits

The skids for these cuts have been greased by decades of lies about anti-poverty programs and their effectiveness. Conservatives usually refer to cutting the safety net as an attempt to reduce “waste, fraud, and abuse,” or end a “culture of dependence”—but in reality it’s simply looking squarely at our neighbors, demonizing them, and then turning our backs. The only thing missing is a spit in the eye for emphasis. The underlying problem is that Americans often buy into conservative rhetoric about “welfare” and an all too often complicit media. A long history of racially coded language has painted people with low incomes as undeserving of assistance, and there is a persistent lack of education about what our safety net is, and who it benefits. How many Americans know that more than 1 in 2 of us will experience at least a year of poverty or near-poverty during our working years?

While conservatives say that people are living off their food stamps, few Americans know that the average benefit is $1.40 per person, per meal. The notion of supporting a family on that is absurd. The public also envisions extensive subsidized housing—it has no idea that only 1 in 4 families that qualify for federal rental assistance actually receive it, and that their average income is approximately $12,500 per year. They think people are getting “free cash,” but cash assistance (TANF) only goes to 23 of every 100 families in poverty nationwide, and the program is virtually nonexistent in many states. (It’s little surprise that a gutted TANF “block grant” is the model for what congressional Republicans would like to do with nutrition assistance, Medicaid, housing, and more—watch it lose value with inflation over the years, and watch fewer and fewer people receive it.)

It also doesn’t matter a whit to conservatives what the evidence says about the kinds of things that make a difference in people’s lives. It doesn’t seem to matter that our antipoverty programs cut poverty in half—that poverty would have been as high as nearly 30 percent in recent years without them; or that girls who had access to food stamps (SNAP) saw increases in their economic self-sufficiency as adults—including less welfare participation—compared to their disadvantaged peers who didn’t have access; or that a little assistance for children up to age 5 is associated with boosted educational performance, and increased work and earnings as adults; or that children under 13 who were able to use a housing voucher to move to a low-poverty neighborhood were 32 percent more likely to attend college and earned 31 percent more annually as young adults, compared to their peers in families that didn’t receive a voucher. Or even that expansion of Medicaid eligibility has reduced infant mortality and childhood deaths, and that children eligible for Medicaid are more likely to go on to graduate college.

You’d think some of these data would make an impression on Speaker Ryan, who is constantly clambering about the need for evidence. The fact is he simply doesn’t like the evidence he sees. When he wrote a report on the “War on Poverty” in 2014, concluding that our antipoverty investments have failed, numerous academics came forward to say that he had misrepresented their work; apparently that was the only way Ryan could support his fictitious thesis.

In the coming months, the fight against conservative proposals that target struggling Americans should transcend the specifics of the policy debate, much as the electoral contest between Doug Jones and Roy Moore transcended the candidates. This is a fight about who we are as a nation, and who we want to be; whether we are comfortable treating people as disposable, or whether we invest in human potential and dignity; and whether we’ll accept conservative charlatans as serious leaders on decisions that have such high stakes. All of the evidence suggests we should reject them.

President Trump and his colleagues in Congress have nearly finalized legislation to secure tax cuts for billionaires and wealthy corporations. After months of wheeling and dealing to secure the votes they need to pass the bill, conservative lawmakers have started to reveal their plans to pay for it—by slashing vital programs like Social Security, Medicare, Medicaid, nutrition assistance, and affordable housing.

I spoke with Representative Jim McGovern (D-MA) to examine where conservatives are headed and what they really mean when they use buzzwords like “entitlement reform” and “welfare reform.”

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Rebecca Vallas: “Robin Hood in reverse” has always been the congressional GOP’s playbook, and their most recent budget proposals released earlier this year were basically a hit list of programs they want to slash. But is it surprising to hear them say it out loud while they’re trying to do “tax reform” that is actually tax cuts for billionaires and corporations?

Rep. Jim McGovern: I’m not surprised because congressional Republicans have never been enthusiastic about programs that feed people who are hungry or provide them health care or some sort of security. They’ve had this kind survival of the fittest approach to government—if you’re well off, great; if you’re not, too bad. But we have a group of Republicans in Congress that are determined to undo all government, and if they succeed with their agenda a lot of people are going to be hurt.

RV: I’ll have to confess, I was surprised to hear Congress dress their calls for cuts to these programs up in their same standard language about deficit reduction and unsustainable deficits. Was it surprising to you?

JM: I mean the tax plan adds over a trillion dollars to the deficit, and this is not a tax cut for the middle class. Basically this is a tax giveaway to big corporation, to those who are very well off and those who are very well connected. It will be a tax increase on middle class families, and it will be a tax increase on those struggling to get into the middle class.

RV: I want to focus on programs that people typically think about as anti-poverty programs. The U.S. Department of Agriculture sent a letter to state food stamp administrators who administer the Supplemental Nutrition Assistance Program (SNAP), and some people have interpreted it as the Trump administration actually encouraging states to take steps to make it harder for struggling workers and families to access nutrition assistance when they need it.

JM: We’re going to have to wait and see what USDA is up to, but they haven’t been very forthcoming and I don’t have a good feeling about this. Conservatives have for years wanted to cut programs like SNAP. They have presented as fact a version of SNAP that is clearly not true—that the program helps people who are lazy, encourages dependency. But of the people on SNAP, the vast majority are not expected to work—they are kids, they’re senior citizens, they’re people who are disabled. The majority of people who can work, do, and they earn so little they still qualify for SNAP.

There are some things we can live without, but food isn’t one of them. The average SNAP benefit is about $1.40 per person per meal. You can’t even buy a cup of coffee with that. We should be talking about expanding the SNAP benefit so that people have the resources to buy not just food, but nutritious food for their families. And we ought to remind people that this program is incredibly successful. It is one of the most efficiently and effectively run programs by the federal government and has very low fraud and error rate. It also is a program that is an economic stimulus—it helps our farmers, our grocers, our economy overall.

To the extent that SNAP needs to be improved, it is that the benefit is inadequate. Most people on SNAP end up having to go to food banks at the end of the month.

RV: So there is a huge gap between what Congressional Republicans make it sound like these programs are about and the reality of who gets helped by them. The fact is that 70 percent of Americans will turn to at least one means-tested program at some point during their lives. But that seems to be the playbook—to flat out lie about what these programs are and who they help.

This Congress has demonized poor people

JM: Right, they promote this myth that somehow programs like SNAP promote dependency. The average time that households are on SNAP is 12 months or less. We do hill briefings with people who had been on SNAP and are now quite successful, and they remind Members of Congress how important that benefit was when they needed it. But this Congress has demonized poor people, belittled their struggle, and blamed them for all of our economic problems.

I wish there was more of an outcry about making sure that work pays in this country. If you work in this country you ought not to have to live in poverty. The fact that we haven’t addressed this issue the way we should is very, very costly. There are all these avoidable medical costs that are associated with food insecurity. Kids can’t learn if they go to school hungry. Workers aren’t productive if they go to work hungry. Senior citizens who have to make choices between prescription drugs or putting food on the table and they choose to take a prescription drug on an empty stomach end up in a hospital. Women who are pregnant don’t give birth to healthy babies unless they have adequate nutrition. And so we need to take this issue more seriously than we have, and we certainly shouldn’t be demonizing people who are struggling.

RV: The federal minimum wage has been stuck at $7.25 an hour for the past almost nine years because Republicans in Congress refuse to raise it. And yet their rhetoric is all about “self-sufficiency.”

JM: The fact of the matter is that the jobs that are out there keep people in poverty. And so when I hear Speaker Ryan or Republicans talk about self-sufficiency I respond by screaming that people are working out there. They’re working harder than ever and they are still stuck in poverty. So let us address the issue of wages. Let’s help lift people up.

[Instead] we have Wisconsin Governor Scott Walker moving forward with drug testing some food stamp recipients. I have an idea. Let’s go drug test Scott Walker—maybe people who have stupid ideas like that ought to be drug tested. Because that is insulting. We’re not saying drug test big heads of defense contractors who get billions of taxpayer dollars. We’re not talking about farmers who get crop insurance, we’re not talking about testing any other recipient of government money—just poor people. That is just offensive and insulting and that’s the kind of stuff that is coming out of this Congress.

Hunger is a political condition when all is said and done.

RV: Do you think that the public still buys Speaker Paul Ryan and President Trump as champions of the forgotten man and the forgotten woman, or do you think that the tax fight has laid bare what they’re really after?

The tax fight has laid bare what they’re really after

JM: Well I think the tax fight has laid bare what they’re really after. I think their attempt to repeal the Affordable Care Act and come up with a replacement that would throw 30 million off of health insurance has shown who they really are. I really believe that a lot of people who may have supported Paul Ryan or Donald Trump in the last go around are now seeing who they really are. These aren’t champions for the forgotten man or woman. And they are not champions for people struggling in poverty. They are the problem; they are the enemy of so many people in this country who are trying to make ends meet. And people need to stand up and fight back.

I’m proud to live in a country that has a program designed to make sure that people don’t go hungry. I’m proud to live in a country that has programs like Medicare that guarantee health care for our older population. I’m glad we have programs like Medicaid. I believe that everybody is important—that nobody should be invisible in this country and that the whole purpose of government is to be there for those who need a helping hand during a very difficult time. Donald Trump doesn’t need government. He’s a billionaire. But there are millions of families in this country that do and they’re every bit as important as he is.

We need to take back our country. We need to watch very carefully what Paul Ryan means by entitlement reform and we have to make sure that he doesn’t view programs like SNAP as an ATM machine to pay for the corporate welfare that is part of their tax bill.

This interview was originally conducted for Off-Kilter. It was edited for length and clarity.